Bilgehan ÇATAL, Mert KESKİNBORA, Elif Nedret KESKİNÖZ, Gamze TÜMENTEMUR, İbrahim AZBOY, Bahtiyar DEMİRALP

Is denervation surgery possible in the treatment of hallux rigidus? An anatomic study of cadaveric specimens

Objective: The aim of this study was to provide anatomic considerations in the first metatarsophalangeal joint (FMPJ)innervation and to evaluate the feasibility of the denervation surgery in the treatment of hallux rigidus.Methods: In this cadaveric study, 14 fresh frozen cadaveric transtibial amputation specimens was used. For nerve dissection,dorsal and plantar longitudinal incision centered over the FMPJ were performed. Deep peroneal and dorsomedial cutaneousnerves were dissected in the dorsal aspect of the joint. Medial plantar nerve branches, medial and lateral hallucal nerves, weredissected in the plantar aspect of the joint. The presence, number, and location of articular branches to the FMPJ capsule wererecorded. Dorsal and plantar incision length for proper dissection were also recorded.Results: Nerve dissection of the 14 specimens revealed the following number of articular branches from the relevant nerves: 14from dorsomedial cutaneous nerves, 11 from deep peroneal nerves, 6 from medial hallucal nerve, and 5 from lateral hallucalnerve. Dorsal incision mean length was 60.53 (range, 42.48˗85.12) mm, and the plantar incision mean length was 88.08 (range,77.32˗111.21) mm.Conclusion: Evidence from this study has shown that partial dorsal denervation of the FMPJ may be a technically feasibleprocedure along with the presence of superficially easily dissected nerves with relatively small incision.Level of Evidence: Level 5

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